Other- Internet Explorer, FireFox, Gmail, Hoot Suite, Citrix, Adobe
Patient Care CoordinatorJun 2016 to Current UnitedHealth Group- Optum 360 － Chandler, AZ
Appropriate patient identification, collecting accurate and thorough patient demographic data, obtaining insurance information and verifying eligibility and benefits.
Maintain up-to-date knowledge of specific registration requirements for all areas, including admitting, outpatient registration, emergency department registration, maternity and rehabilitation units.
Obtaining and documenting referral, authorization and pre-certification information in ADT systems and submit notice of admission when necessary.
Complies with HIPPA, PHI, ABN, MSP, EMTALA and other regulations that affect the registration process.
Thoroughly and accurately documents insurance verification information in the ADT system, identifying deductibles, copayments, coinsurance, and policy limitations.
Meet CMS billing requirements for the completion of the MSP, issuance of the Important Message from Medicare, issuance of the Observation and documenting completion within the hospital's information system for regulatory compliance and audit purposes.
Collaborates with physician offices and clinical areas to collect and share patient information, assisting with updating stakeholders on changes in Patient Registration requirements, processes or programs.
Clarifies payment and billing assistance program to all patients regardless of financial concerns or limitations.
Function as a liaison to other hospital departments regarding insurance benefits, requirements and collaborates with other departments to ensure proper compliance with third party payer requirements.
Clinical Administrative CoordinatorJul 2013 to Feb 2016 UnitedHealth Group － Honolulu, HI
Facilitated insurance notifications consisting of inpatient and outpatient hospital admissions, durable medical equipment, procedures, physical, occupational and speech therapies, enteral, incontinence, home health and skilled nursing facilities.
Corresponded with patients, medical providers and customer service inquiries by composing notifications, interpreting provider's status of an existing notification and articulating if notification is required.
Collaborated with prior authorization nurses, inpatient care managers and acute utilization management to integrate and discuss clinical requests.
Delegated to complete Queen's Medical Center census reports of inpatient hospital admissions and facility discharges.
Created daily prior authorization queue reports requested by clinical administration management, prior authorization nurses and prior authorization coordinators.
Implemented the Hawaii Pacific Health and Queen's Medical Center Obs.er.ver pilot program utilizing Emergency Room admissions amongst Medicare and Medicaid members.
Facilitated inter-island travel requests and reports for members seeking specialists regarding medical appointments and procedures.
Exemplified expertise and proficiency in ICD-9, ICD-10 and CPT coding, specialty software and validating.
Promoted to telecommuting by demonstrating consistent established productivity, schedule adherence and quality standards while maintaining excellent attendance.
Jul 2012 to Dec 2012 Boston, MA
Educated and informed the public, patients and medical professionals about clinical research and the role each party plays in the process in advancing medical science.
Conducted literature reviews and data extraction to determine which studies best support specific outcomes in pharmaceutical research.
Aided members of the public in finding ongoing clinical trials by searching government registries.
Composed articles for the bi-monthly newsletter The Participant and exemplify issues affecting all the stakeholders in the clinical research enterprise.
Executed the placement of the public service campaign Aware-For-All and integrate informational workshops with renowned physicians and researchers, provide health screenings and additional educational resources.
Researched grant opportunities, partnership opportunities and coordinated event planning for educational programs in cities.
Implemented a marketing and sales plan for educational materials to promote awareness of clinical research participation.
Food Service AssociateJun 2009 to Jan 2013 Winchester Hospital － Winchester, MA
Served food to patients and cafeteria customers as specified by menus, ensuring that all food items were properly portioned and handled within established sanitation standards.
Assisted in patient tray line and cafeteria setup, ensuring that quality standards were maintained and safe food handling guidelines were adhered to.
Monitored food storage units to insure safe temperatures for patients, employees and customers.
Operated, loaded and unloaded dish machine, stored clean items; inspected washed items for cleanliness and breakage.
Education and Training
Bachelor of Science, Public Health- Biology Program LeadershipMay 2013Simmons College Macquarie University － Boston Sydney, MAGPA: Dean's List Fall 2012Public Health- Biology Study Abroad Program Australia Spring 2012
International semester with focus on health promotion, ecological humanities and geographies of health
Leadership , Awards and Activities Dean's List Fall 2012
Macquarie Global Leadership ProgramSimmons College Success Connection
Conversational French and Spanish.
Acid, Adobe, Microsoft Applications, benefits, billing, bi, Citrix, clinical research, clinical trials, CMS, CPT coding, customer service, educational materials, educational programs, event planning, Fast, financial, focus, Conversational French, government, health promotion, home health, ICD-10, ICD-9, insurance, Internet Explorer, Leadership, regulatory compliance, Macintosh, marketing and sales, Excel, Outlook, PowerPoint, Word, MiniTab, enterprise, newsletter, nursing, processes, quality, rehabilitation, research, Spanish, speech, SPSS, Word Processing, workshops, articles